Access to Mental Health Services in Emergencies
Mental health crises can strike at any moment, often triggered or exacerbated by emergencies such as natural disasters, conflicts, pandemics, or personal traumas. Ensuring access to mental health services during these critical times is not just a necessity but a fundamental aspect of humanitarian response and public health. In regions like rural Nigeria, where organizations like the Cope and Live Mental Health Awareness Foundation (through its educational arm, COLI Academy) are making strides, addressing these challenges requires coordinated efforts, innovative solutions, and a commitment to equity.
The Importance of Mental Health in Emergencies
Emergencies, whether sudden-onset like earthquakes and bereavement or prolonged like refugee crises, create immense psychological stress. Survivors may face grief, fear, displacement, or loss of livelihoods, leading to or worsening conditions like anxiety, depression, post-traumatic stress disorder (PTSD), or substance abuse. For example, studies following natural disasters, such as Hurricane Katrina in 2005 or the 2010 Haiti earthquake, showed PTSD rates as high as 30% in affected communities. In Nigeria, the ongoing conflict in the Northeast has led to significant mental health challenges, with a 2020 study by the International Organization for Migration (IOM) reporting that 60% of internally displaced persons (IDPs) in Borno State exhibited symptoms of depression or anxiety.
Mental health is often sidelined in emergency response, overshadowed by immediate physical needs like food, shelter, and medical care. Yet, neglecting mental health can hinder recovery, resilience, and community rebuilding. Timely mental health support, including counseling, can reduce suffering, prevent chronic conditions, and empower individuals to cope with adversity. The Cope and Live Mental Health Awareness Foundation emphasizes compassionate, accessible counseling for vulnerable groups—children, teens, pregnant women, seniors, and displaced persons—creating safe spaces to foster emotional well-being during crises. This foundation's work extends to supporting caregivers, who are on the frontlines of emergency response and face unique psychological burdens, ensuring that those providing care are equipped to sustain their efforts without burnout.
Barriers to Access
Access to mental health services during emergencies is often limited by systemic, logistical, and cultural factors:
Resource Scarcity: In low-income regions like rural Nigeria, mental health infrastructure is minimal. The World Health Organization (WHO) estimates a global shortage of over 4 million mental health workers, with Nigeria having only 0.15 psychiatrists per 100,000 people. During crises, these resources are stretched even thinner, exacerbating challenges for caregivers who must manage their own mental health alongside patient care.
Logistical Challenges: Disrupted infrastructure, such as damaged roads or communication networks, can prevent access to services. In conflict zones like Nigeria’s Northeast, security risks limit mobility for both patients and providers, while understaffing in healthcare facilities compounds the strain on existing workers.
Stigma and Awareness: Cultural stigma around mental health deters help-seeking. In rural Nigeria, mental health issues are often stigmatized as spiritual afflictions, discouraging treatment. A 2021 study in the Journal of Global Health found that 70% of Nigerians with mental health needs avoid care due to stigma. This is particularly acute among caregivers, who may hide their struggles to maintain a facade of strength.
Inequity in Access: Vulnerable groups—children, women, the elderly, and IDPs—face disproportionate barriers. For example, displaced women in Nigeria may lack documentation or face language barriers, while cultural norms may restrict their access to care without family approval. Parents of children with special needs, often thrust into crisis-like daily management, grapple with additional layers of guilt, shame, and isolation.
Funding Gaps: Mental health services are underfunded in humanitarian response. The WHO notes that only 0.5% of global health funding in low-resource settings goes to mental health, despite its critical role in recovery. This shortfall directly impacts initiatives supporting caregivers, leaving systemic issues like understaffing unaddressed.
Strategies to Improve Access
To address these challenges, governments, NGOs, and communities must prioritize mental health as an integral part of emergency response. Below are key strategies, with examples from the Cope and Live Mental Health Awareness Foundation’s HopeWorks Mission initiatives in rural Nigeria, including its Support for Caregivers Initiative (SCGI):
Integrate Mental Health into Primary Care: Embedding mental health services within emergency health frameworks maximizes reach. The WHO’s Mental Health Gap Action Programme (mhGAP) trains primary care workers to manage basic mental health conditions. In rural Nigeria, Cope and Live integrates counseling into primary care through maternal mental health outreaches, using tools like PHQ-9 screenings to identify and support women with postpartum depression or anxiety. SCGI extends this by training healthcare practitioners at facilities like the Model Health Care Centre in Ozalla to recognize and address compassion fatigue, secondary trauma, and moral distress, ensuring frontline workers can deliver better care.
Mobile and Telehealth Solutions: Mobile clinics and telehealth platforms deliver mental health support to remote areas. During the COVID-19 pandemic, organizations like Médecins Sans Frontières used tele-counseling to reach isolated populations. Cope and Live offers tele-counseling for transporters in rural Nigeria, providing stress management tools like breathing exercises to mitigate crisis-related stress. SCGI incorporates virtual peer support networks to help caregivers combat work-life imbalance without disrupting high-stakes environments.
Community-Based Approaches: Training community health workers, peer supporters, or local leaders in psychological first aid (PFA) extends care to underserved areas. Cope and Live’s Community Mental Health Ambassadors Program trains volunteers in rural Nigeria to promote awareness, identify distress, and refer individuals to services, creating a ripple effect in communities. Their Mother-to-Mother (M2M) peer support initiative empowers women to sustain long-term support networks. Under SCGI, programs for parents of children with special needs—such as the September 25, 2025, psychosocial engagement at Alex Ekwueme Federal University Teaching Hospital in Abakaliki—focus on emotional management, self-care, and stigma reduction, equipping parents with strategies like mindfulness and intentional parenting to handle guilt, anxiety, and burnout.
Emergency Preparedness Plans: Including mental health in disaster preparedness ensures rapid response. Stockpiling psychotropic medications, training responders in PFA, and establishing referral pathways are critical. Cope and Live conducts needs assessments with local stakeholders to tailor programs, ensuring culturally relevant interventions before crises escalate. SCGI's September 26, 2025, outreach in Ozalla introduced the E+R=O (Event + Reaction = Outcome) framework, teaching caregivers proactive coping like positivity and resilience training to prepare for high-stress scenarios.
Address Stigma: Public awareness campaigns normalize mental health care. Cope and Live’s Mental Health Education Workshops for Youth use storytelling and drama in schools to reduce stigma, reaching up to 50–100 students per session in rural Nigeria. Their Menstrual Health Outreaches address emotional challenges tied to menstruation stigma, empowering girls and women. SCGI events foster openness by encouraging discussions on challenges like financial stress and dysfunctional family dynamics, distributing assessment forms for anxiety and depression to normalize early intervention.
Target Vulnerable Populations: Tailored interventions are essential for groups like children, who benefit from play-based therapies, or displaced persons, who need multilingual services. Cope and Live’s School-Based Mental Health Clubs engage up to 50–100 students with art therapy and mindfulness, while their maternal outreaches provide safe spaces for up to 20–30 pregnant and nursing mothers per session, addressing postpartum mental health challenges. SCGI specifically targets caregivers of special needs children, dispelling myths about conditions like cerebral palsy and Down syndrome, and promoting acceptance through personal storytelling and peer encouragement.
Increase Funding and Advocacy: Donors must prioritize mental health funding in emergency budgets. Cope and Live partners with corporations for CSR initiatives, offering scalable programs like vocational training with mental health integration, which supports out-of-school youth with skills and counseling to build resilience. Advocacy through SCGI calls for systemic changes, such as fair compensation and policy reforms to tackle understaffing, amplifying caregivers' voices for broader impact.
Success Stories and Innovations
Initiatives worldwide and in Nigeria demonstrate the potential for effective mental health interventions in emergencies. In Ukraine, mobile mental health teams have provided counseling to thousands in war-torn areas since 2022. In Bangladesh’s Rohingya refugee camps, the IOM has reached over 100,000 people with psychosocial services since 2017. In Nigeria, Cope and Live’s Maternal Mental Health Outreaches have supported up to 50–80 women per program, training peer facilitators for the M2M initiative to sustain community support. Their counseling services, accessible at www.copeandlive.foundation/counselling-form, offer judgment-free spaces for children, teens, seniors, and displaced persons, using tools like critical thinking to guide clients toward solutions.
SCGI has yielded inspiring outcomes, such as the Ozalla outreach where nurses shared experiences of financial and familial stressors, gaining tools to foster resilience and reduce turnover. In Abakaliki, parents of special needs children reported breakthroughs: one mother committed to public outings with her child to combat shame, while another highlighted her child's artistic YouTube channel (@AdaureIdika) as a stigma-busting success. These events built community, enhanced coping mechanisms, and empowered participants with hope, reducing isolation and promoting self-care like rest, hydration, and social engagement.
Technological innovations are also transforming access. The WHO’s “Step-by-Step” digital mental health program has been piloted in crisis settings, offering guided self-help for depression and anxiety. Virtual reality therapy is showing promise for PTSD treatment in disaster survivors. In rural Nigeria, Cope and Live leverages low-tech solutions like community-based counseling and helplines to reach underserved populations, ensuring accessibility despite limited digital infrastructure, with SCGI emphasizing peer networks and workshops for sustained impact.
The Way Forward
Ensuring access to mental health services in emergencies requires treating mental health as equally critical as physical health. In rural Nigeria, Cope and Live Mental Health Awareness Foundation is leading the way through culturally sensitive, community-driven programs. Their counseling services—offered in individual and group sessions for children, teens, pregnant women, and underserved communities—mitigate crises by fostering emotional well-being and resilience. By integrating mental health into emergency response systems, leveraging community ambassadors, empowering vulnerable groups through initiatives like M2M peer support and youth mental health clubs, and bolstering caregivers via SCGI's targeted outreaches, we can build hope and healing.
Mental health care in emergencies is a right, not a luxury. As global crises grow, organizations like Cope and Live show that scalable, equitable solutions are possible. To support or sponsor their transformative workshops in rural Nigeria, contact info@copeandlive.foundation or visit www.copeandlive.foundation/counselling-form to explore counseling services. Together, we can foster hope, healing, and human dignity in the face of adversity.
About the Writer:
Mrs Uzoamaka Nwachukwu is the Co-Founder of Cope and Live Mental Health Awareness Foundation. She is a highly qualified professional with expertise as a Trained Child Psychologist, Microbiologist, Grief & Bereavement Counsellor, Depression Counsellor, Emotional Intelligence Life Coach, EMDR and CBT Life Coach, and Mental Health First Aider. Her love for children, passion and knowledge make her a leading voice in mental health advocacy.
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